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A letter from the SHHD to Dr Maycock addressed the question of how much plasma the Blood Products Unit in Edinburgh would fractionate for England and Wales.

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Dr Gunson and Dr Helen Dodsworth wrote "Fifty Years of Blood Transfusion" published in Transfusion Medicine which outlined the history of transfusion medicine in England and Wales.

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PFC first produced factor concentrates in January 1975, and reached full capability using "9 to 5" production in 1976.

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The Immuno Limited Table of Supply for Kryobulin and Bebulin 1969-1972 showed that Kryobulin was first used in the UK in 1970.

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Dr Biggs wrote to Professor Edward Blackburn regarding the problem of coming up with a 10-year estimate of how much blood would need to be collected in the UK. The subjectivity of clinical need, as well as the difference between "demand" and "need" for treatments meant that it was not easy to identify.

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A memo from Donald Jackson to Michael Lillywhite (DHSS) illustrated the difficulty of of providing an estimate for the level for production which would achieve self-sufficiency.

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John Watt wrote to Dr Rosemary Biggs expressing that one standard view at the time was that people with haemophilia needed to be able to live a normal sedentary lifestyle.

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There was always self-sufficiency in blood. London private hospitals would source blood from abroad and when they were over-provided, they would then pass their surplus to the NHS. Some patients in London would be given blood which was not necessarily tested in the same way as NHS blood would have been nor sourced from voluntary donors.

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Malcolm Widdup wrote to Andrew Mitchell to say more AHF/AHG was needed and Dr Bigg's view was convincing enough that the Treasury were prepared to fund preparations to meet it.

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England had a number of reference centres with haemophilia centres within their area. Oxford was the reference centre for the Alton Centre which served Treloar's school.

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Professor Blackburn wrote to Sir George Godber that directors felt an urgent need to increase supplies of Factor 8 concentrate because if British preparation could not be made available, commercial preparations should be bought.

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Dr Maycock wrote to Dr Reid that the UK should aim to be self-sufficient in the supply of preparations of anti-haemophilic globulin and Factor 9.

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Sir George Godber wrote to Sir Philip Rogers that due to increasing expenditure on commercial products being licenced there was a need to consider how far the home supply could be increased, leading to a lower cost.

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Sir George Godber wrote to Sir Philip Rogers that the expense of producing commercial or domestic concentrate was thought to be unavoidable in principle and providing domestic supplies would likely be cheaper than purchasing commercial concentrate.

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The initial aim was to supply concentrate made from 250,000 donations for use in home treatment, with the balance being cryoprecipitate.

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The supply of plasma for cryoprecipitate and for sending it to make concentrate at that stage was 300,000 donations a year.

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Dr John Wallace argued that the threshold required was that an adequate amount of a good quality cryoprecipitate would probably cover most clinical indications for Factor 8 therapy.

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In a meeting it was stressed that Dr Bigg's paper indicated in five years time there may be a need for more material, haemophilia centre directors and transfusion directors approved the contents of the paper and recommended that this document be used as the basis for planning the future requirements for Factor 8 in the United Kingdom.

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Dr Biggs argued that the problem pertained to large available stocks of therapeutic materials in stores because no-one would buy them whilst patients were simultaneously in dire need of this same material.

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In Lord David Owen's response to parliamentary questions he argued that concentrates were the optimum treatment and commercial product was available. However, UK domestic production should increase and home treatment was desirable.

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